Consumer Law: Cashless Hospitalization Scrapped
According to consumer law, you can sue an insurer, if he fails to pay your insurance claim. Recent news reports indicate that some of India’s leading insurance companies stopped their cash-less hospitalization plans. Also, several of them closed payment of treatment costs to selected hospitals.
Public sector companies, such as United India, New India, Oriental Insurance and National Insurance, along with 18 other companies have withdrawn cash-less mediclaim services, from some of the high-end hospitals in Delhi, NCR region, Bangalore and Mumbai, such as Apollo, Escorts, Fortis, Max and Rockland. This surprising move has left many consumers in a lurch.
To understand what a cashless mediclaim policy is, read on. This is just a facility that takes care of your hospital charges without hassle of paying cash right then. Typically, the health insurance companies associate themselves, with hospitals after negotiating their charges and examining their quality. If you get admitted in their network of hospitals, you don’t have to pay the hospital bills as you can opt for the cashless facility.
Consumer Law: Penalize the Culprits, Not Patients, is the Official Stand of Hospitals
In accordance with consumer law, most insurance companies were earlier offering the cashless service to their consumers. Now, they are alleging that hospitals make false claims and show high costs so that they can charge more from the insurers. With the stoppage of this facility, it means that the consumers, who wish to use the services of these hospitals, will now have to pay cash. Only after making the payment in the hospital, they will be entitled to claim the insurance amount. However, the insurance companies offer no guarantee that they will be compensated the full amount.
The concerned hospitals are outraged, by the decision. Their official stand is that insurance companies should comply with the legal process to penalize the culprits, instead of targeting established hospitals and impacting the patients.
With criticism, disbelief and consumer protests soaring, the Insurance Regulatory and Development Authority of India (IRDA) has decided to scrutinize the matter and take suitable action after discussion with all the stakeholders. In general, people across the country view this sudden change of policy, as breach of trust and contract by their insurance providers. Patients who are forced to pay hefty hospital bills in cash are sure to file legal suits as they would be blaming the insurers for their loss.
People who want to misuse it will misuse the cashless as well as the the new one. Insurance companies will now make patients and their family members suffer for claims.
In today's time we can not even rely on the well reputed companies like "Oriental Insurance" etc.
Me and all my family members have there mediclaim policies since 10 year and above, but till date I am not at all satisfied with any of there services because of their Incompetent agents and service providers.
I had already faced a big problem in the past with this company when we waited extremely long for the repayment of hospital bills & the refund of the left over policy amount of my dad's policy after he passed away in 2006,we ran every where but no one paid any attention to our problem, then we requested consumer court to file our case against the company etc. it took lot of time more then 1.5 years for solving the problem with the help of top company officers, who were very understanding and really helpful to us, I am still thankful to all who understood us and helped us.
Today I felt forced to write this mail coz of Mr. A.K CHOUDHARY's continues Irresponsible behavior and also filed a case in consumer court http://www.consumercourt.in/medical-insurance/1093-mediclaim-policy-orie... , from last many year (almost 3-4 years) every time he came for the renewal of the policy, always took our photos for the cashless cards etc but always misplace it and never send the cashless card ever on time, sometimes cards comes after 5-6 months but along with the time the delay time was not reduced rather was becoming worse, all the times we submitted the photos twice or even thrice but this time from last almost 8-9 months we haven’t received our cashless card as yet, even they delay in sending the complete policy papers many times.
We as an old and loyal customers never said anything from so long time but now this is the height of irresponsibility on company's part.
Now i am no more interested to continue my policy, rather this time I’ll close it down with this company once and for all.
Regards,
Pranjal
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